TUE Information

What is a TUE?

Athletes, like other persons, may have illnesses or conditions that require them to take medications. If the medication an athlete is required to take happens to fall under the World Anti-Doping Agency’s (WADA) Prohibited List, a Therapeutic Use Exemption (TUE) can give the athlete authorization to take the needed medicine.

Athletes are not automatically granted authorization and must ensure they follow the appropriate process for their sport and competition level.

TUEs are only granted by National Anti-Doping Organizations (NADOs) such as the NADC, International Federations (IFs) and Major Event Organizers (MEOs) following a robust review process that is defined in the International Standard for TUE (ISTUE). In order to obtain an approval for a TUE, athletes must have a well-documented medical condition supported by reliable and relevant medical data.

NADC TUE Downloads

Common questions about TUE’s

For all queries not covered below, please contact us.

Who should apply for a TUE?

All athletes who are subject to doping controls, that is drug testing, must be aware of the TUE rules and requirements that apply to them. These rules and requirements will vary depending on the athlete and will determine when and to which organization an athlete must submit a TUE application. It is the athlete’s responsibility to ensure that they meet all TUE requirements imposed by the National Anti-Doping Commission or their respective International Federation (IF).
Please contact the National Anti-Doping Commission or your respective IF to find out what requirements apply to you.

Under what circumstances will a TUE application be approved?

A TUE application will be considered by the National Anti-Doping Commission under the following circumstances:

the substance/medication or method is needed to treat an acute or chronic medical condition, such that the athlete would experience a significant impairment to health if the prohibited substance or method were to be withheld;

the use of the prohibited substance/medication or method would produce no additional enhancement of performance other than that which might be anticipated by a return to a state of normal health following the treatment of a legitimate medical condition; and

there are no reasonable therapeutic alternatives or other alternatives are ineffective.

How do I apply for a TUE?

Use the National Anti-Doping Commission TUE application form and submit it to the National Anti-Doping Commission with all required supporting documentation.

Application timelines and information:

A complete TUE application can be reviewed within 21 days of receipt of the complete application.

The National Anti-Doping Commission will contact the athlete once a decision has been rendered on the application, or if more information has been deemed necessary.

Costs incurred for the completion of the TUE application form or additional investigations, examinations, or imaging studies are the responsibility of the athlete.

The National Anti-Doping Commission will confirm receipt of a TUE application by email.

Incomplete applications will be returned and will need to be resubmitted with additional information.

Keep a copy of your application form and medical file for your records.

Start of Medical Treatment

If the TUE is approved, the athlete can only begin treatment after the reception of the approval notice from the National Anti-Doping Commission. Athletes should not start using the substance before receiving the authorization notice from the National Anti-Doping Commission. The athlete would then be using a prohibited substance or method without authorization and this could constitute an anti-doping rule violation in the event that the TUE is denied by the TUEC.

In rare emergency or exceptional cases, a retroactive approval may be considered (please see section titled “What is a retroactive TUE?”).

What is a retroactive TUE?

The retroactive TUE application process may only be granted if:

Emergency treatment or treatment of an acute medical condition was necessary; or

Due to other exceptional circumstances, there was insufficient time or opportunity for the athlete to submit, or for the TUE Committee to consider, an application for the TUE prior to Sample collection; or

The applicable rules required the athlete or permitted the athlete (see the World Anti-Doping Code Article 4.4.5) to apply for a retroactive TUE; or

It is agreed, by WADA and by the Anti-Doping Organization to whom the application for a retroactive TUE is or would be made, that fairness requires the grant of a retroactive TUE.

What should I do in case of an emergency or acute treatment?

Your health and safety come always first. Any decision made regarding your treatment plan should be done in consultation with your physician. Once your treatment is being managed, contact the National Anti-Doping Commission to determine your medical exemption requirements, and to download the application form if required.

What should I do if I have surgery?

Prior to surgery, ask your physician for a list of the medications that will be used. Contact the National Anti-Doping Commission to determine your medical exemption requirements, and to download the application form if required.

How long is my TUE valid?

A TUE granted by the National Anti-Doping Commission TUE Committee is valid for the duration of the treatment as prescribed by the physician. It is your responsibility to know when your TUE expires and to apply for renewal before this date if necessary.

What should I do if my competition level changes?

A National Anti-Doping Commission TUE is granted in accordance with the TUE rules of the National Anti-Doping Commission and is valid only in Barbados, unless otherwise stated in your International Federation’s anti-doping rules. If at any time you are included in your IF’s Registered Testing Pool (RTP) or compete at an international level, you must comply with their IF TUE requirements. You should contact the National Anti-Doping Commission to determine whether your National Anti-Doping Commission TUE is valid for international competition.

TUE Review Process

If the National Anti-Doping Commission denies an application for a TUE, the athlete may appeal exclusively to the national level appeal body described in the National Anti-Doping Commission anti-doping rules.

If WADA determines that the granting or denial of a TUE did not comply with the International Standard for TUEs in force at the time, then WADA may reverse that decision and the TUE shall be cancelled. In the event of a reversal, WADA will advise all concerned parties.

WADA shall review any decision by an IF not to recognize a TUE granted by National Anti-Doping Commission that is referred to WADA by the Athlete or National Anti-Doping Commission. In addition, WADA shall review any decision by an IF to grant a TUE that is referred to WADA by the National Anti-Doping Commission. WADA may review any other TUE decisions at any time, whether upon request by those affected or on its own initiative. If the TUE decision being reviewed meets the criteria set out in the International Standard for Therapeutic Use Exemptions, WADA will not interfere with it. If the TUE decision does not meet those criteria, WADA will reverse it.